Medical and Dental Claims Analyst

Grade 4 - salary dependant on experience and qualification. Our full family health, welfare, and defined benefit pension programs add $12.49 per hour to all of our compensation packages.

Summary of essential job functions:

This position requires the employee to be responsible and proficient in, but not limited to the following:

• Adhere to all established policies and procedures
• Review and resolve benefit related discrepancies
• Request Trust required information necessary to determine benefit allowance.

• Adjudicate all claim types accurately and thoroughly
• Meet minimum production standards as established by the Claims Manager.
• Identify and communicate claims system and/or billing problems to the Lead Analyst and/or Claims Manager.
• Resolve personal daily aging claims and error reports
• Resolve and handle all attention mail daily
• Answer phone calls timely and accurately. Research the call and seek assistance from a Lead Analyst if necessary.
• Resolve as assigned / identified daily reports
• Meet or exceed claim accuracy and timeliness standards established by the Claims Manager.
• Research and correct all errors as identified by internal/external claim audit.
• Cross training on other Funds as assignedMust have a thorough knowledge of each Trust?s policies and procedures and apply them to the daily duties of this position.

The above duties are not to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities from time to time as needed.